Die-hard Obamacare supporters are in full denial over the lousy results of the health care plan in its first year. They’re tone deaf, living a delusion. This piece from Forbes.com notes that the Affordable Care Act (ACA) has been an abject failure thus far on six of seven major counts, and even the one “success” is terribly blemished. Close to 90% of the increase in the number of insured is due to expansion in the Medicaid and state Children’s Health Insurance Program roles. Both of those welfare programs predate the ACA and certainly could have been expanded without Obamacare and its collateral damage to existing health plans and the health care industry. In fact, according to Business Week, less than half of physicians now accept Medicaid, so it’s not always easy for those “newly insured” individuals to gain access to actual care.

In fact, Medicaid patients are not the only ones with access problems. This USA Today article linked by Forbes notes that physicians are limiting the number of Obamacare exchange-covered patients they’ll accept. After the disastrous unraveling of the “if-you-like-your-plan-you-can-keep-it” fiction, it was revealed that many of the policies foisted upon the “previously-insured-but-no-longer” group through Obamacare exchanges offered severely limited provider networks. If you liked your doctor, you might well have lost your doctor.

For the majority who do not qualify for taxpayer subsidies under Obamacare, the health insurance premia on policies acquired on the exchanges have risen drastically. This problem is covered in the Forbes article. Far less expensive short-term plans are being offered by insurers as an alternative to Obamacare, but they are only renewable if the insured remains healthy. It is precisely these kinds of circumstances that might devolve into a death spiral for Obamacare: an increasingly sick risk pool and universal rating may lead to accelerating premium hikes for the exchange policies.

So, prospects for improvement under the ACA are quite bleak. We’ve seen a botched rollout of the Obamacare website, the chief enrollment vehicle, which is still problematic; a wrecked individual market with policies cancelled and replaced by coverage with limited provider networks; a medical device industry battered by new taxes; a negative impact on full-time employment as firms reduce hours to avoid coverage requirements; expanded welfare programs with a concomitant burden on taxpayers; increased emergency room utilization; physicians opting out due to inadequate reimbursement and high compliance costs; healthy individuals opting out and sick individuals opting in; higher premia with more increases on the way and the prospect of an insurance death spiral; and we’ve seen arbitrary exemptions carved out for various cronies of the Obama administration all along the way. Oh, and we’ve seen lies, delays, and every effort to back-load costs and front-load benefits, an implementation governed by political considerations rather than improving health care. The next shoe to drop is likely to be widespread cancellation of employer-sponsored coverage as the ACA coverage mandate hits employers in 2015.

Desperate propaganda continues to flow, but that can’t change the fact that Obamacare is terrible policy with results to prove it. Here is government failure.